Provider Demographics
NPI:1184115917
Name:LUKE, NEETI PRERANA
Entity type:Individual
Prefix:MISS
First Name:NEETI
Middle Name:PRERANA
Last Name:LUKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NASSAU UNIVERSITY MEDICAL CENTRE,
Mailing Address - Street 2:2201 HEMPSTEAD TURNPIKE
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554
Mailing Address - Country:US
Mailing Address - Phone:516-572-0123
Mailing Address - Fax:
Practice Address - Street 1:2525 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4518
Practice Address - Country:US
Practice Address - Phone:952-992-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2024-08-27
Deactivation Date:2019-01-22
Deactivation Code:
Reactivation Date:2019-01-31
Provider Licenses
StateLicense IDTaxonomies
NY311496208000000X
MN760312080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics